How to create a fair radiologist pay-for-performance program

Employees who feel valued are more engaged and motivated – including radiologists. In a field like radiology, where burnout is high, it’s especially important to understand what makes staff feel appreciated. In an internal survey[i], partners of a private practice radiology physician group were asked which of the following two things are most important to you as a shareholder:

1. earning potential,
2. practice stability
3. flexibility of work schedule (expected work/life balance)
4. clinical tools and clinical operations.

In their response, 70.37% of the radiologists selected flexibility of work schedule as one of their answers. 55.56% of respondents selected earning potential as one of their answers. 40.74% of respondents selected practice stability as one of their answers. And 22.22% of respondents selected clinical tools and clinical operations as on of their answers.

Perhaps not surprisingly, earning potential and flexibility of schedule (work/life balance) were selected the most. These may seem like opposing preferences that traditionally have been difficult to balance in a practice – until now.   

Recent innovations in technology are making it possible to implement fair radiologist compensation programs that overcome the challenges that once seemed insurmountable such as:

• Recognizing individual radiologist productivity with a metric better than the wRVU. One that more accurately reflects the radiologist work effort not only recognizing the exam description but also considering relative case complexity.
• Awarding appropriate credit for non-interpretive work
• Preventing system gaming
• Protecting quality

Productivity is just the beginning

With radiologists in scarce supply and coupled with declining reimbursements, to ensure continuity of timely services, radiology practices have no choice but to focus on productivity. This means practices often look towards performance transparency and robust reporting, to best manage its critical radiologist workforce and ever-growing clinical workload. Novel pay for performance programs must be initiated to facilitate radiologist performance optimization while improving job satisfaction.

Until now, these have been mostly built utilizing relative value units (RVUs). But, rewarding only based on RVUs creates an environment where essential skills go unrecognized and important tasks remain undone. When only RVU work is incentivized, unintentional and unwanted outcomes can include:

• Avoidance and delays of more complex cases
• Inadequate clinical follow-up
• Decrease in overall quality
• Lack of critical relationship-building that promotes practice expansion
• System gaming, such as cherry-picking
• Staff dissatisfaction

Assessing a radiologist’s relative accuracy

In addition to measuring radiologist productivity, it’s equally important to monitor accuracy and quality. Yet, this can be very difficult to objectively define and measure. While radiologists typically know intuitively who they would ask to read a family member’s exams, defining accuracy more objectively can be a problematic.

Audits can help capture the critical accuracy metric. Unfortunately, audits can also be very time consuming, expensive, and inefficient if the correct parameters are not in place. Therefore, any incentivization system needs to be counterbalanced by enhanced auditing capabilities. The ability to target audits and resulting actionable insights about each radiologist’s relative accuracy would leave to measurable quality improvements.  

What about non-interpretive tasks?

While it is the delivery of RVUs that provides the radiology practice’s revenue stream, it is often non-interpretive components that contribute to essential functions that both build the practice and improve overall quality. But how can compensation be linked to these critical non-interpretive tasks?

To date, demonstrating radiologists’ contributions beyond quickly and accurately reading exams has been extremely difficult. However, new developments in creating truly intelligent workload management systems can provide an easy, non-intrusive way to track the completion of educational, administrative, and patient-facing activities. For example, enabling a radiologist to quickly log activities such as performing a surgical consult or participating clinical and educational conferences makes it feasible to capture these non-interpretive tasks and ultimately link those activities to increases in overall quality. This data may even be used to negotiate professional services agreements and justify compensation for non-interpretive responsibilities.

 As a result, the radiology practice can recognize and reward the diverse range of skills required in the radiologist’s essential role on the care delivery team. When both interpretive and non-interpretive contributions are valued, it increases quality and improves the overall success of the enterprise.

Supported by analytics and technology

Fairly recognizing and incentivizing each radiologist’s individual contributions – it’s no longer just aspirational; it’s now possible to optimize radiologists’ workflow across an entire enterprise and enable equitable pay-for-performance programs.

Is your radiology practice seeking these outcomes? Discover how GE Healthcare’s PACS solution integrated with intelligent workload management solutions from Quantum [ii] can help radiology leadership:

• Enable staff to read at peak efficiency across the enterprise
• Improve radiology productivity
• More accurately predict and distribute workload
• More fairly measure performance against compensation
• Reduce radiologist burnout
• Improve turn around times and overall enterprise performance

Bottom line, GE Healthcare’s PACS solutions with Quantum’s workforce and workload automation technology can enable radiology practices to more fairly manage work distribution and develop effective pay-for-performance programs.